Does your child need a Speech Language Pathologist or an Occupational Therapist?

Behind their Bite: When your child needs more than mom?
By Laura Cipullo, RD, CDE, CEDRD, CDN and Mom

 

Is your kid a picky eater, or is something else going on?  Read on to learn if your child needs an evaluation by a speech and language pathologist or occupational therapist.

 

The logic behind why a child does or doesn’t eat something is difficult to understand. There is no clear and easy direction to point when determining the preferences of one taste or texture to another. In fact, there can actually be a variety of factors at play.

 

If your child is showing signs of picky eating alongside a series of additional symptoms, he/she may need more than mom. Symptoms would include hypersensitivity to textures, tags in clothing, delays in daily activities such as dressing, brushing teeth, sitting and standing, slow developmental skills in the classroom and with crafts, delayed or slurred speech, excessive drooling while eating, coughing while swallowing, and/or difficulty chewing and swallowing.

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Ideally it is best to work with a team of health care professionals, who can help you assess if your child’s aversion to certain foods is more than picky eating. A team would consist of a pediatrician, a psychologist, a speech and language pathologist, an occupational therapist, a registered dietitian and of course, the parents. In the perfect situation the team would do the following:

Sample case: Greg, age 4, makes a horrible face each time he sees and tries broccoli. He will not swallow it and spits it out. Claims it hurts his stomach.

  • A doctor will test to make sure there isn’t an allergy or sensitivity causing the stomach pain.
  • A psychologist, if required, will consult with the doctor to see if there is any pattern of disordered eating or need for therapy.
  • A speech and language pathologist will assess his ability to swallow, chew, and move the food through his mouth and esophagus to make sure there are no issues with feeding and swallowing.
  • An occupational therapist, in this particular situation, will assess anything that ranges from the plate to the motion of putting food into the mouth and the various factors that may affect this.
  • Using all of this information, and barring any allergies/sensitivities, a dietitian will help to integrate this food into the child’s diet or help find an alternative nutrient and/or food sources to replace this food in his diet.
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Realistically parents do not always have access to this kind of multidisciplinary team. Remember it that it takes roughly 10-15 tries before a child acclimates to a new food. If your parent’s intuition leads you to believe something else is getting in the way, use the tips below to determine who should evaluate your child’s eating.

  • Get Evaluated by a Speech and Language Pathologist if:
    • Coughing or choking upon swallowing
    • Gaging
    • Poor tongue motion or movement
    • Inability to close lips while chewing and swallowing
    • Non-food behaviors (that could indicate challenges in overall sensory integration or motor planning affecting eating):
      • Hypersensitive to textures (e.g. Avoids “messy” crafts or toys such as painting, glue, play dough, sand box)
      • Hypersensitive to tags in clothing
      • Delays in other daily living activities (dressing, brushing teeth, climbing in and out of chair, manipulating toys, writing, cutting with scissors)
      • Late talkers
      • Excess drooling
      • Articulation errors (unclear speech)

 

  • Get Evaluated by a Occupational Therapist if:
    • Hypersensitivity to taste, texture, or tags
    • Refusal or inability to lift silverware
    • Refusal or inability to eat
    • Spiting food out
    • Throwing food
    • Any mechanical or behavioral interruption of feeding before consumption of food
    • Delays in development
      • Dressing
      • Brushing teeth
      • Climbing in and out of chair
      • Manipulating toys
      • Writing
      • Cutting with scissors, crafts

 

Look out for clues that suggest there may be a swallowing disorder or an inhibition restricting your child to self-feed outside of just being a picky eater. And remember, sometimes people just don’t like certain flavors or textures—and maybe that is what’s behind their bite.

 

Is your child a picky eater? What signs do they show that they dislike food, taste, or texture? 

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